5.2 Cuff and Tonometer Based Device for Assessment of Carotid to Femoral Pulse Wave Velocity: Validation According to Artery Society Guidelines

Background There is increasing interest in cuff-based devices for assessment of arterial pulse wave velocity (PWV). A recently developed device utilises a thigh cuff and carotid applanation tonometry for assessment of carotid to femoral PWV (cPWV; SphygmoCor XCEL, AtCor Medical; test device). Our aim was to validate the device against ECG gated tonometric measurement of PWV (tPWV) (SphygmoCor CvMS; control device) according to Artery Society Guidelines [1]. Methods We recruited 94 subjects (48 female, 22–83 years, mean age 45.6 ± 19.4) in 3 centres (Australia, France, Italy). The thigh cuff was inflated automatically to sub-diastolic pressure and the cuff waveform was recorded simultaneously with the tonometric carotid waveform. Control and test devices were used in random order. PWV was determined from wave foot-to-foot delay and distance from suprasternal notch to femoral site or top of cuff, minus distance from suprasternal notch to carotid site. The average was computed of triplicate measurements by two operators. Results A high correlation was found between devices (R 2 = 0.90; Figure) with a mean difference of -0.02 ± 0.61 (SD) m/s. Mean difference and standard deviation (SD) between cPWV and tPWV was well within the “excellent” category acceptance criteria of the Artery Society guidelines (